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Purpose
– The purpose of this paper is to test an initial model of safety climate for firefighting. Relationships between safety climate, safety behaviors and firefighter injuries were examined.


Design/methodology/approach
– Data were collected from 398 professional firefighters in the southeastern USA. Structural equation modeling, using a zero-inflated Poisson regression method, was used to complete the analyses.


Findings
– Safety climate, as a higher order factor, was comprised of four factors including management commitment to safety, supervisor support for safety, safety programs/policies and safety communication. Both safety compliance behaviors and safety participation behaviors were significantly, positively associated with safety climate. Both behaviors were deemed protective and were associated with reductions in injury. Safety climate relations to injury were interesting, but somewhat ambiguous. Safety climate significantly predicted membership in the "always zero" injury group. For those not in the "always zero" group, the relationship between safety climate and injury was positive, which was not completely surprising as direct relationships between safety climate and injury have been insignificant and opposite to predictions in studies using retrospective data and may be attributed to reverse causation.


Originality/value
– This novel study illustrates the importance of both organizational and work unit factors in helping shape safety climate perceptions among firefighters. The results also support the safety climate – behavior – injury model and show that a positive safety climate encourages safer behaviors among firefighters. Lastly, the findings confirm that both safety compliance behaviors and safety participation behaviors are important to reducing individual firefighter injury experience.

This article argues that efforts to improve the health and well-being of the workforce should begin with the organization itself. The term organizational health promotion is introduced to expand the scope of worksite health promotion. Organizational health promotion delves into the basic structural and organizational fabric of the enterprise—to how work is organized. The core themes of healthy work organization are introduced, and the status of our ability to identify organizational risk factors is discussed. A conceptual model of healthy work organization is presented, along with a process for expanding the health promotive capacity of the organization. The final section addresses challenges related to adopting an organizational health promotion perspective.

Purpose. To compare the effectiveness of stage-matched vs. social-cognitive physical activity interventions in a work setting. Both interventions were designed as minimal-contact, self-help programs suitable for large-scale application. Design. Randomized trial. Participants were randomized into one of the two intervention groups at baseline; the follow-up assessment was conducted 1 month later. Setting. A large, public university in the southeastern region of the United States. Subjects. Employees from two academic colleges within the participating institution were eligible to participate: 366 employees completed the baseline assessment; 208 of these completed both assessments (baseline and follow-up) and met the compliance criteria. Intervention. Printed, self-help exercise booklets (12 to 16 pages in length) either (1) matched to the individual's stage of motivational readiness for exercise adoption at baseline or (2) derived from social-cognitive theory but not matched by stage. Measures. Standard questionnaires were administered to assess stage of motivational readiness for physical activity; physical activity participation; and exercise-related processes of change, decisional balance, self-efficacy, outcome expectancy, and goal satisfaction. Results. The two interventions were equally effective in moving participants to higher levels of motivational readiness for regular physical activity. Among participants not already in maintenance at baseline, 34.9% in the stage-matched condition progressed, while 33.9% in the social-cognitive group did so (x2 = not significant). Analyses of variance showed that the two treatment groups did not differ in terms of physical activity participation, cognitive and behavioral process use, decisional balance, or the other psychological constructs. For both treatment groups, cognitive process use remained high across all stages, while behavioral process use increased at the higher stages. The pros component of decisional balance did not vary across stage, whereas cons decreased significantly between preparation and action. Conclusions. Minimal-contact, one-shot physical activity interventions delivered at work can help people increase their participation in regular physical activity. Stage matching may not necessarily add value to interventions that otherwise make good use of behavior change theory. The findings also reinforce the importance of barrier reduction in long-term adherence. A limiting factor in this study is that employees in the earliest stage of change (precontemplation) were not well-represented in the sample.

FUEL Your Life is a worksite translation of the Diabetes Prevention Program that was tested in a large transportation company to determine its effectiveness. The effectiveness study utilized an experimental control group design where six worksites were randomly assigned to treatment and control conditions (three sites per condition), with the control group receiving no planned intervention. Outcome measures were collected pretest, posttest (6 months), and follow-up (12 months) via biometric measures and surveys. After posttest data were collected on all of the sites, it became apparent that one of the worksites in the control group had significantly increased their weight loss activities to "make the site look better." This is referred to as compensatory rivalry where social competition may motivate a control site to show it can perform as well as the treatment sites despite not getting the same benefits. This is a threat to the internal validity of the study. This case study will detail the research study and the activities of the confounding site, demonstrate the impact that site had on the overall outcomes of the study, and discuss lessons learned from our experience that can be applied to field research, particularly when conducted in worksite settings.

Purpose.To evaluate the effectiveness of FUEL Your Life, a translation of the Diabetes Prevention Program for worksites.Design.A randomized control group design was conducted in five worksites of a large transportation company. Measures were collected pretest, posttest (6 months), and follow-up (12 months).Setting.Railroad maintenance facilities of Union Pacific Railroad.Subjects.Participants consisted of 362 workers (227 treatment, 135 control).Intervention.FUEL Your Life was translated from the Diabetes Prevention Program to better fit within the context of the worksite. The primary difference was the use of peer health coaches to provide social support and reinforcement and an occupational nurse to provide lesson content (six sessions of 10 minutes) to participants instead of the lifestyle coaches employed by the Diabetes Prevention Program, resulting in a less structured meeting schedule.Measures.The primary outcomes were weight and body mass index (BMI), with secondary outcomes including eating behaviors, physical activity, and social support.Analysis.Latent growth modeling was used to measure changes in the outcomes over time.Results.Participants in the intervention group maintained weight/BMI (–.1 pounds/–.1 BMI), whereas the control participants gained weight/BMI (+2.6 pounds/+.3 BMI), resulting in a statistically significant difference between groups. Fifty-five percent of intervention participants lost some weight, whereas only 35% of the control group lost weight.Conclusions.FUEL Your Life, a low intensity intervention, was not effective for promoting weight loss, but was effective for helping workers maintain weight over a 12-month period.

This commentary reviews findings from the four previous national surveys of workplace health promotion activities (1985, 1992, 1999, and 2004, respectively) and offers recommendations for future surveys mandated under the Affordable Care Act of 2010. Future surveys should place greater emphasis on assessing program quality, reach, and effectiveness. Both employer and employee input should be sought. In addition, sampling plans should differentiate worksites from employers, and results should include public as well as private sector organizations. Ideas are offered for addressing these limitations and for creating a sustainable survey process and multifunctional database of results.

Purpose. This study documents the prevalence of workplace health promotion activities at small worksites with 15 to 99 employees. Design. A random sample of U.S. worksites stratified by size and industry (n = 3628) was drawn using American Business Lists. Measures. Each worksite was surveyed using a computer-assisted telephone interview system to document activities related to health promotion and related programs, worksite policies regarding health and safety, health insurance, and philanthropic activities. Subjects. Participation varied by industry and size, with an overall response rate for eligible worksites of 78% for a total sample of 2680 worksites. Data Analysis. Data were analyzed using SUDAAN statistical software. Results. Approximately 25 % of worksites with 15 to 99 employees offered health promotion programs to their employees, compared with 44% of worksites with 100+ employees. As with the larger worksites, the most common programs for worksites with 15 to 99 employees were those related to occupational safety and health, back injury prevention, and CPR. The majority of worksites in both size categories had alcohol, illegal drug, smoking, and occupant protection policies. The majority of both small and large worksites also offered group health insurance to their employees (92% and 98%, respectively), with many of the worksites also extending benefits to family members and dependents (approximately 80% for both business sizes). Conclusions. The results indicated that small worksites are providing programs to their employees, with a primary focus on job-related hazards. Small worksites also have formal policies regarding alcohol, drug use, smoking, and seatbelt use and offer health insurance to their employees at a rate only slightly lower than that of large worksites.

PurposeThe purpose of this study is to examine when perceived organizational support (POS) may be more likely to play a mediator versus moderator role in stressor and strain relationships by considering POS relative to challenge and hindrance stressors, cognitive/emotional and physical strains.Design/methodology/approachThis cross‐sectional survey research was conducted in two samples (n=720, 829) of employees working for a large retail organization in the USA. Hypotheses were tested using structural equation modeling.FindingsAs hypothesized, results indicate POS mediates relationships between hindrance stressors and cognitive/emotional strains, but does not mediate relationships between challenge stressors and physical strains. POS does not moderate any of the relationships examined.Originality/valueThis paper is one of few studies to examine challenge and hindrance stressors and to examine POS relative to physical strains.

Purpose: Examine the moderating role of perceived organizational and coworker support on the relationship between job stress and type 2 diabetes risk among employees. Design: A cross-sectional survey was administered to employees at the workplace. Setting: One national retail organization. Participants: Baseline data were obtained from 1595 employees in 21 retail stores. Measures: Self-reported organizational and coworker support to encourage and fulfill job responsibilities and job stress. Diabetes risk was calculated using age, gender, race/ethnicity, blood pressure, physical activity, weight status, and self-reported diagnosed type 2 diabetes. Analysis: Multilevel multiple regression was conducted to test the interaction effect of support on the association between job stress and diabetes risk. Results: Mean age was 37.95 years (±12.03) and body mass index was 26.72 (±4.95). Three percent of participants reported diagnosed diabetes. Organizational support was positively associated with coworker support. Both were negatively associated with job stress. Organizational support, but not coworker support, moderated the relationship of job stress with diabetes risk. Participants with greater perceived organizational support had lower diabetes risk scores compared to those with lower perceived organizational support. Conclusion: Organizational support may be a key factor for workplaces to reduce stress and diabetes risk. Further testing of organizations' supportive role on employee health may be helpful in developing future workplace programs.

Purpose. Describe the development of the leading by example (LBE) instrument. Methods. A total of 135 responses from employees of a private corporation working at 11 different worksites were factor analyzed in 2005. Exploratory factor analysis was used to obtain an initial factor structure. Factor validity was evaluated using confirmatory factor analysis methods. A second sample was collected in 2006 from the same population (N = 178) and was used to confirm the factor structure via confirmatory factor analysis. Cronbach's α and item-total correlations provided information on the reliability of the factor subscales. Results. Four subscales were identified: business alignment with health promotion objectives, awareness of the health-productivity link, worksite support for health promotion, and leadership support for health promotion. Factor by group comparisons revealed that the initial factor structure was effective in detecting differences in organizational support for health promotion across different employee groups. Conclusions. Management support for health promotion can be assessed using the LBE, a brief self-report questionnaire. Researchers can use the LBE to diagnose, track, and evaluate worksite health promotion programs.

Purpose. This study tested a repeated-measures application of the Leading by Example (LBE) questionnaire, a self-report instrument measuring organizational leadership support for health promotion. Design. The efficacy of the LBE was tested in a quasi-experimental health promotion intervention trial. Twelve worksites were assigned to three intervention conditions (i.e., control, moderate, high intensity). Setting. The worksites were selected from a large U.S.-based chemical company. Subjects. Baseline data were collected from employees in various job roles in 2005 (N = 125). Follow-up data were collected in 2006 (N = 114) and 2007 (N = 106). Response rates ranged from 54% to nearly three-fourths of potential respondents. Intervention. Worksites assigned to both treatment conditions received changes in the built environment via supports for weight management. Worksites assigned to the intense condition received additional elements designed to impact leadership's support for a positive health promotion climate. Measures. Four LBE factors measuring management support for health were assessed over time. Analysis. The Kruskal-Wallis H-test and analyses of variance/covariance were used to compare LBE scores. Results. Significant changes from baseline to 2006 were identified for the four factors (p = .000) of the LBE. No significant changes were found from 2006 to 2007. Conclusions. The LBE effectively captured perceptions of management support for health. Researchers and practitioners alike should consider using the LBE to track and evaluate perceptions of management support for health promotion.

Purpose:Report the results of a randomized, controlled trial of Live Healthy, Work Healthy (LHWH), a worksite translation of the Chronic Disease Self-Management Program (CDSMP).Design:14 worksites were randomly assigned to LHWH, standard CDSMP (usual care) or no-intervention (control) group.Setting:The diverse set of work organizations centered around a rural community in SE US.Subjects:411 participants completed baseline data with 359 being included in the final analyses.Intervention:LHWH had been adapted to fit the unique characteristics of work organizations. This translated program consists of 15 sessions over 8 weeks and was facilitated by trained lay leaders.Measures:The primary outcomes including health risk, patient-provider communication, quality of life, medical adherence and work performance were collected pretest, posttest (6 mos.) and follow-up (12 mos.).Analysis:Analyses were conducted using latent change score models in a structural equation modeling framework.Results:79% of participants reported at least one chronic condition with an average of 2.7 chronic conditions reported. Results indicated that LHWH program demonstrated positive changes in a most outcomes including significant exercise (uΔ = 0.89, p < .01), chronic disease self-efficacy (uΔ = 0.63, p < .05), fatigue (uΔ = −1.45, p < .05), stress (uΔ = −0.98, p < .01) and mentally unhealthy days (uΔ = −3.47, p < .001).Conclusions:The translation of LHWH is an effective, low cost, embeddable program that has the potential to improve the health and work life of employees.